This article was co-authored by Jonas DeMuro, MD. Dr. DeMuro is a Board Certified Pediatric Critical Care Surgeon in New York. He received his MD from Stony Brook University School of Medicine in 1996. He completed his fellowship in Surgical Critical Care at North Shore-Long Island Jewish Health System and was a previous American College of Surgeons (ACS) Fellow.

There are 14 references cited in this article, which can be found at the bottom of the page.

A broken bone is a serious physical trauma. Attached muscles, tendons, ligaments, blood vessels, and even nerves can be damaged or torn by the bone’s destruction. “Open” fractures are accompanied by a visible, open wound, and can cause infection. A “closed” fracture — when the bone is broken without obvious skin injury and with less trauma than the open fracture — is still a painful experience which needs time to heal. Within these two basic types of fractures, there are a multitude of other classification schemes.

Look for open fractures. An open fracture is one where the bone breaks clear through the skin. Also known as compound fractures, this type of fracture carries the threat of contamination and infection.[1]XTrustworthy SourceWorld Health OrganizationHealth information and news provided by the World Health OrganizationGo to source Look closely at the area around the impact or suspected breakage. If you see bone protruding from the skin, or if there is any visible bone, you have an open fracture.

Learn about closed fractures. Closed fractures, as the name implies, occur when the bone breaks but does not break through the skin.[2]XResearch source Closed fractures may be stable, transverse, oblique, or comminuted.

A stable fracture is one in which the broken bone is aligned properly and just barely out of place. These are also referred to as non-displaced fractures.[3]XResearch source

An oblique fracture is one in which the breakage occurs on an angle relative to the alignment of the bone.

A comminuted fracture (also known as a segmented fracture) is one in which the bone breaks into three or more piece.[4]XResearch source

A transverse fracture is one in which the breakage occurs in a more or less straight line perpendicular to the alignment of the bone.

Identify fractures in which bone is impacted. There are two kinds of fractures which meet this criteria and they can be difficult to differentiate.[5]XResearch source Impaction fractures (also known as buckled or impacted fractures) typically occur at the end of long bones when a bone fragment is forced into another piece of bone. Compression fractures are similar, but are usually found in vertebrae when spongy bone collapses upon itself.

Compression fractures heal naturally over time, though they should be monitored. Impaction fractures will require surgery.

Recognize incomplete fractures. Incomplete fractures do not result in two separate pieces of bone, but may still show typical symptoms of fracture. There are several variants of incomplete fractures:[6]XResearch source

Greenstick fractures are incomplete transverse fractures, reported mostly in children since immature bones don’t totally break under pressure into two parts.[7]XTrustworthy SourceMayo ClinicEducational website from one of the world's leading hospitalsGo to source

Hairline fractures (also known as fissure fractures or stress fractures) may be difficult to identify with X-rays as they appear as very fine lines. They might be visible only several weeks after being incurred.

Depression fractures are those which have been pressed in from without. Where multiple fissure lines intersect, the whole section of bone might be depressed.

Incomplete fractures share almost the same symptoms as complete fractures. If the limb is swollen, bruised, or twisted, it may be fractured. The limb might be deformed or out-of-shape, dangling at a bent or awkward angle. If the pain is so excruciating that the limb cannot be used comfortably or support weight, it is likely fractured.

Understand variant fractures. There are many other classifications of fractures based on the specific location or manner of the injury.[8]XResearch source Knowing the fracture types can help you better understand, avoid, and treat fractures.

Spiral fractures result when excessive torsion or twisting force is applied to a limb, fracturing the bone.

Longitudinal fractures occur when the bone breaks along a vertical axis in a parallel path through the bone.

Avulsion fractures are those which occur when a bone fragment from the main bone at a site of a ligament attachment to a joint breaks. This may happen in motor accidents while trying to help the casualties by pulling them from their arms or legs, affecting their shoulders or knees.

Listen for a snap. If you heard a snap from your limb during a fall or sudden impact, it's likely your bone is fractured. Depending on the force, severity, and angle, the bone may crack (fracture) in two clean pieces or many. [9]XResearch source This sound you hear is actually the sound of the bone or group of bones that received the sudden impact and damage.

The grating or snapping sound caused by the bone when fractured is known in technical literature as "crepitation."

Feel immediate, intense pain followed by numbness and tingling. There may also be a burning pain (except with skull fractures) that changes in intensity right after the injury. Numbness or coldness may set in if the area below the fracture is not receiving enough blood. As muscles cope to hold the bone in place, you may experience muscle spasms as well.

Look for tenderness, swelling, and bruises with or without bleeding. The swelling of the surrounding tissues occurs due to damaged blood vessels, causing the leakage of blood at the affected site. This then leads to an accumulation of fluids, bringing about swelling that causes pain when touched.

This blood in the tissues is visible as bruising. Bruises will start purple/blue, then turn green and yellow as the blood is reabsorbed. You may find bruises some distance from the actual site of the the fracture as the blood from the broken vessels move through your body.

External bleeding will only occur if the fracture is open, and the broken bone is exposed or protruding from the skin.

Look for a deformation of the limb. The injury may cause a deformity depending on the severity of the fracture. For instance, perhaps the wrist is bent at an odd angle. Perhaps the arm or leg has an unnatural-looking bend where there is no joint. In the case of a closed fracture, the bone's structure has changed inside the limb. In the case of an open fracture, the bone is projecting outward at the site of injury.

Be aware of the signs of shock. In cases of massive blood loss (including internal bleeding), blood pressure may drop precipitously, leading to shock. Individuals suffering from shock might grow pale and become warm or flushed, but later, excessive dilation of blood vessels might cause people to have cold, clammy skin. They may grow silent, confused, sick, and/or feel light-headed. Their breathing might be rapid initially, but slow down to dangerous levels if blood loss is severe.

It is normal for an individual to undergo shock as the injury takes its toll. Some people, however, feel few symptoms of shock and do not perceive they have suffered a bone fracture. If you experience a violent impact and evince even one symptom of shock, seek medical help immediately.

Look for a decreased or abnormal range of motion. If the broken bone is located next to a joint, you'll likely have trouble moving the limb as normal. This is a sign the bone is fractured. Movement of the limb may be impossible without experiencing pain, or you may not be able to put weight on the affected body part.

Your doctor should check for other signs of fracture such as pulse, skin discoloration, temperature, hemorrhage, swelling, or wounds. All of this will help him quickly assess your condition and best course of treatment.

Get X-rays taken. This is the first course of action in the event a bone fracture is suspected or detected.[10]XTrustworthy SourceMayo ClinicEducational website from one of the world's leading hospitalsGo to source X-rays can detect fractures and assist doctors in analyzing the extent of your injury.

Before starting, you will be asked to remove any jewelry or metal parts on your person, according to the area that will be examined. You may have to stand, sit or lie down, and will be asked during the process to remain still or even hold your breath.

Have a bone scan done. If an X-ray cannot detect a fracture, a bone scan might be used as an alternative. Bone scans are imaging tests not unlike a CT scan or MRI. A few hours before you have the bone scan done, you’ll be injected with a small amount of radioactive material. Doctors can trace the course of the radioactive material through your body in order to identify where bone material is being repaired.[11]XResearch source[12]XTrustworthy SourceMayo ClinicEducational website from one of the world's leading hospitalsGo to source

Request a CT (computed tomography) scan. CT scans are perfect for examining internal injuries or other physical trauma. Doctors perform these when they know they’re dealing with complex, multi-fragment bone breakage. By combining multiple X-ray images into a single image with computer processing, doctors can obtain more three-dimensional view of the fracture with a CT scan.[13]XTrustworthy SourceMayo ClinicEducational website from one of the world's leading hospitalsGo to source

Consider getting an MRI (magnetic resonance imaging) done. An MRI is a test which employs radio pulses, a magnetic field, and computers to obtain detailed images of the body. In the case of a fracture, the MRI can offer more information about the extent of damage. It is useful for differentiating between bone damage and damage to the cartilage and ligaments.[14]XResearch source

About this article

This article was co-authored by Jonas DeMuro, MD. Dr. DeMuro is a Board Certified Pediatric Critical Care Surgeon in New York. He received his MD from Stony Brook University School of Medicine in 1996. He completed his fellowship in Surgical Critical Care at North Shore-Long Island Jewish Health System and was a previous American College of Surgeons (ACS) Fellow.

If you’re unsure whether you have a fracture or not, try and remember if you heard a snap during impact, which would signify a fracture. You might also feel sudden, intense pain or a burning sensation followed by numbness and tingling, which suggests the area below the fracture is not receiving enough blood. Also, look for tenderness, swelling, and bruising, which may accompany bleeding or occur on its own. Additionally, if your damaged bone is located next to a joint, you’ll probably have a decreased or abnormal range of motion. If you think you’ve fractured a bone, you should seek medical attention immediately. For more tips from our Medical co-author, including how to identify different types of fractures, read on!